Description
A 40-year-old woman underwent a tonsillectomy due to recurrent tonsillitis and previous left peritonsillar abscess. During the surgery, it was noticed that the left-side tonsil was adherent to the tonsillar fossa. Intubation, surgery and the recovery period were uneventful. The next morning, the patient developed left-side facial and neck swelling extending to the midline. Clinical examination showed non-tender soft swelling and crepitus with no shortness of breath nor trismus. Neck X-rays confirmed the diagnosis of surgical emphysema (figure 1A,B). Consequently, the patient was kept nothing by mouth and fed through a nasogastric tube. Intravenous antibiotics and steroids were initiated along with instructions to avoid straining or coughing. Swelling improved gradually and disappeared completely on the fourth postoperative day when she was started on clear oral fluids. With no continuing clinical concerns, she was upgraded to full diet and discharged with follow-up, which showed normal healing...
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